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Full text of "Medicaid at-a-glance, 2002 : a Medicaid information source"

Department of Health and Human Services 
Centers for Medicare & Medicaid Services 
Center for Medicaid and State Dperatidns 




Medicaid At- a- Glance 
2002 

A Medicaid Information Source 



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The Medicaid Program 
Key Eligibility Groups 
Mandatory State Plan Services 



State Chart 



Optional Medicaid Plan Services 
Federal/State Matching Rates for Services 



Federal Poverty Guidelines 



PUBS 

RA 

412 

.4 

M422 

2002 



THE MEDICAID PROGRAM 



KA 

,/■"» The Medicaid Program provides medical benefits to low- 
income people who have no medical insurance or 
inadequate medical insurance. Although the Federal gov- 
ernment establishes general guidelines for the program, 
the Medicaid program requirements are actually established by each 
State. Whether or not a person can be eligible for Medicaid will depend 
on the State where he or she lives. 




KEY ELIGIBILITY GRDUPS 




States are required to include certain types of individuals 
or eligibility groups under their Medicaid plans and they 
' may include others. Following are brief descriptions of 
uSm some of the key mandatory and optional eligibility 
groups included under states' plans. These descriptions do not include 
all groups. For more information on all Medicaid groups contact your 
state. (Also see http://www.cms.gov/medicaid/eligibility for 
more information.) 

Medicaid eligibility is divided into three groups: a) categorically 
needy, b) medically needy, and c) special groups. In addition to the 
Medicaid program, states have a health insurance program for children 
under age 19, the State Children's Health Insurance Program. In some 
states the Children's Health Insurance program is part of the state 
Medicaid programs, and in other states it is separate. 



CATEGORICALLY NEEDY 




Families who today meet states' Aid to Families with 
Dependent Children eligibility requirements in effect 
on July 16, 1996. 

Pregnant women and children under age 6 with 
family income up to 133% of the Federal poverty level. 



Children ages 6 to 19 with family income up to 100% of the 
Federal poverty level. 

Caretakers (relatives who take care of children under age 18 
(or 19 if still in high school)). 

SSI (Supplemental Security Income) recipients or aged, blind and 
disabled who meet requirements that are more restrictive than 
those of the SSI program (often called 1634 or 209(b) states) 
instead of all SSI recipients. 

Individuals and couples who are living in medical institutions and 
who have monthly income up to 300% of the SSI income 
standard (Federal benefit rate). 



FEDERAL PDVERTY LEVEL CHARTS 



The 2002 Poverty Level Charts are used by state Medicaid 
agencies in developing eligibility criteria for various 
Medicaid groups. In some cases the law requires states to use 
a percentage of poverty as the income threshold while in 
other cases states have elected to use percentages of poverty 
for their eligibility criteria. 










2002 POVERTY LEVEL GUIDELINES 












1 1 












ALL STATE':. lEXC EP1 ALA':>h A AN', HAWAII AMD DO" 












1 1 1 1 












Income Guidelines as Published in the Federal Register on 2/14/02 














1 1 
















ANNUAL GUIDELINES 
















. 








FAMILY 


PERCENT OF POVERTY 
















SIZE 


100% 


I 20' ■-• 


1 IV. 


135% 


150% 


175% 


185 


200% 


250% 































1 


8.860.00 


10.632 00 


11,783 80 


11,961 00 


13 


290 00 


15 


sno 


M 


16 


391.00 


\! 


720.00 


22.150.00 


2 


11,940 00 


14 


328 00 


15.880.20 


16,11900 


17 


91000 


21 


K'l< 


00 


22 


089.00 


.'■' 


380 00 


29,850 00 


3 


15.020 00 


If 


024 00 


19.976 60 


20,277.00 


22 


530.00 


.'< 


.W 


III 


11 


787 00 


in 


040 00 


37,550.00 


4 


18,100 00 


2 


720 00 


24.073.00 


24,435 00 


27 


150.00 


i 


1.7' 


)() 


33 


180 IHI 


ii 


200 00 


40. .'So on 


5 


21.180 00 


2£ 


J II, I.HI 


28,16940 


28,593.00 


.11 


770.00 


1 


00' 


J') 


t f 


183 00 


4. 


160 00 


S2,'jS0 0n 


6 


24,260 00 


:•■ 


112.00 


32,265.80 


32.751 00 


If 


390,00 


-J- 


40' 


00 


44 


881 00 


48 


520 00 


00.850 0(1 


7 


27.340.00 


32 


B08 i ii. i 


36.362.20 


36,909.00 


41 


010 00 


■1 


."..]'- 


JO 


5C 


579 00 


04 


680 00 


08 ;S0 00 


8 


30.420 00 


36 


504 00 


.],■ .:',.-. i, n 


41,067 00 


45 


630.00 


53 


.•y. 


10 


56 


277 00 


60 


840 00 


7O.05O On 






















For lamily unils of more thao 8 members, add S 1.080 tor e.s.rh .vt.liri. ui,il mi.-mrjer 






















































MONTHLY GUIDELINES 

























1 AMU , 


PERCENT OF POVERTY 
















SIZE 


100% 


120% 


1 33% 


1 .'.so. 


150% 


175% 


185% 


200% 


250% 































1 


738.33 


8B6.00 


'.HI ',H 


■■''■ 


1.107 50 


1.292.08 


1.365.92 


1,476,67 


1,84583 


2 


995,00 


1.194.00 


1,323.35 


1 ii ■■ .."■ 


1 492 50 


1 


'41 25 


1,840 75 


1,990.00 


2,487.50 


3 


1,251 67 


1 


.(),' 


in 


i.hh.l /.' 


1,689,75 


1.877 50 


2 


190 42 


2.315.58 


.'M.; '.'. 


3,129.17 


4 


1,508.33 


I 


-jir 


10 


2.006.08 


2,036.25 


.' 262 50 


2 


539.58 


2,790.42 


3.01667 


l 770 111 


5 


1,765.00 


2 


18 


-jo 


2,347.45 


2,382.75 


.'>!,■ '--ii 


3 


088 75 


3,265.25 


3.530 00 


4 4 1 ,: '-.i: 


6 


2.021.67 


2 


12': 


"JO 


2.68882 


2,729 25 


3,032 50 


3 


537.92 


3,74008 


H i . H ;'. 


5,054.17 


7 


2,27833 


2 


' 14 


00 


3,030 16 


3,07575 


3.417 50 


3 


987 08 


4 J 14 '■-..' 


4.556 67 


5,69583 





: OlSnn 


3 


>41 


10 


3.371.55 


3,422.25 


3.802.50 


■i 


436 25 


4,68975 


5.070 00 


6,337 50 









2002 POVERTY LEVEL GUIDELINES 




































ALASKA 




































Income Guidelines as Published in the Federal Register on 2/14/02 














I I 
















ANNUAL GUIDELINES 




























FAMM . 


PERCENT OF POVERTY 
















SIZE 


100% 


120% 


133% 


135% 


150° 


175% 


185% 


200% 


250°/ 
































1 


11.080 


on 


13 


296.00 


14.716 40 


14.958 00 


16 


82C 


00 


19 


..■in nn 


20.498.00 


22.160.00 


27.700 00 


2 


14,930 


00 


17 


916.00 


19.856.90 


20,155 50 


22 


<-9 c 


00 


26 


127 50 


27,620 50 


29.860.00 


37.32500 


3 


18.780 


00 


22 


536.00 


24.977.40 


25,353.00 


..'ii 


17( 


l(.) 


32 


865.00 


34,743.00 


37,560.00 


46,950 00 


4 


22.630 


nn 


..'7 


156.00 


30,097.90 


30,550.50 


-..' 


J4<= 


00 


v 


602.50 


41,865.50 


45,260.00 


56,57500 


5 


26.480 


00 


31 


776.00 


35,218.40 


35,748.00 


/. 


u-i. 


11) 


■ii 


340.00 


48,988.00 


52,960.00 


66,200.00 


6 


30.330 


nn 


3f 


396.00 


40.338.90 


40,945.50 


4'- 


<<.,<: 


no 


S3 


077 50 


56,110.50 


60.660 00 


75.825 00 


7 


34.180 


on 


-ii 


01600 


45,459.40 


46,143.00 


c l 


'71. 


00 


">' 


815.00 


63.233.00 


68 160 00 


SO ISO Oil 


8 


38.030 


00 


45 


h J6 i II 1 


50.579.90 


51,340.50 


57 


"U c 


10 


66 


552 50 


70 )55 50 


76.060 00 


95,075 00 






















For family units of more than 6 men, her., .nld S i 850 lor e.irh additional member. 






















































MONTHLY GUIDELINES 




























FAMIL r 


PERCENT OF POVERTY 
















SIZE 


100% 


120% 


133 ■■■ 


1 )5% 


150% 


175% 


185% 


200% 


250% 
































1 


923.33 


1,108.00 


1,228 03 


1.246.50 


1.385.00 


1,615 83 


1.708 17 


1 846 67 


2 


108 33 


2 


1,244,17 


1,493.00 


1.654.74 


1,679.63 


1.866.25 


2,177.29 


2.301 71 


.1 


488 33 


i 


1 ■: 4.' 


3 


1,565.00 


1,878.00 


2,081 45 


2,112.75 


2,347.50 


2,738.75 


2.808 2S 


' 


130.00 


1 


912.50 


4 


1,885 83 


2,263.00 


2,508.16 


2.545 88 


2.828,75 


3,300.21 


3.48879 


1 


r;\ 67 


4 


714 58 


5 


2.206.67 


2,64800 


2,934.87 


2,979.00 


3,310.00 


I On I 1,7 


4.082 33 


4 


11 1 ii. 


' 


516.67 


6 


2,527.50 


3,033,00 


3,361.58 


3,412.13 


3,791.25 


4.4:i 1 1 


4,67588 


' 


055.00 


f- 


31875 


7 


2,848.33 


3,418.00 


3.78828 


3,84525 


4,272.50 


4.984 58 


5,269 42 


1 


696 67 


7 


12083 


8 


3,169.17 


3,80300 


4.214.99 


4.278 38 


4,753 75 


5.546 04 


5,862 96 


<: 


338.33 


7 


92292 









2002 POVERTY LEVEL GUIDELINES 






























HAWAII 


































Income GunJ'iin' 1 Publis t in the Federal Register on 2/14/02 














1 1 
















ANNUAL GUIDELINES 


























FAMIL, 


PERCENT OF POVERTY 
















SIZE 


100':.;, 


120% 


1 ) 3% 


1 35% 


150% 


175% 


185% 


200% 


ISO",, 





























' 


10,20000 


12,240.00 


1 ', 566 ) 10 


13.770.00 


15 


W 


nn 


17,850.00 


18,870,00 


20.400 00 


25,500 00 


2 


13,740 00 


10.48k Oo 


If-; ,.'74 j'i 


IK 84' i n:. 


20 


OK 


OU 


24,045.00 


25,41900 


27.480 00 


...l iOni ... 


1 


17.280 00 


20,736.00 


l.'V,j.K 


23.328,00 


25 


:.,'. 


10 


30.240,00 


11 '..,:■: nn 


34.560.00 


4 ,. '.' 


4 


20.820 00 


24.084 Oo 


27.690.60 


JK ir,,' IK, 


11 


JJO 


1111 


36,435.00 


38.517.00 


41.640 00 


52.050.00 


'1 


24.360.00 


29.232.00 


32.398 80 


32.886.00 


■-> 


S41 


nn 


42,630.00 


45,066.00 


48,720.00 


60,900.00 


6 


27.900 00 


33.480 00 


17.107 no 


37.665.00 


11 


HS( 


nn 


48.825.00 


51.61500 


',0 800 110 


69,750.00 


■ 


31.440.00 


37.728.00 


41.815.20 


42.444 00 


47 


10' 


nn 


55,020.00 


58,164 00 


62,880.00 


78,600.00 


8 


34.980 00 


41.976 00 


46.523 40 


47 ..'.". nn 


52 


1 !'. 


nn 


61,215.00 


64,71300 


69.960,00 


87,450.00 






















For family umls of more Irian 8 members, add S3, 540 for each additional member 






















































MONTHLY GUIDELINES 


























1 AM II , 


PERCENT OF POVERTY 
















SL'L 


100% 


120% 


133% 


! IV.. 


150% 


17 0"., 


185% 


200% 


20fio;, 





























■ 


850 00 


1.020.00 


1 . 1 11 1 SO 


1.M7 SO 


1,275.00 


1 ::■■.; sn 


1,572.50 


1,700.00 


2.12s 00 


..: 


1.145.00 


1.374.00 


1 822 8'1 


1 ',4', ,''. 


1,717.50 


2.001 75 


2 


118 25 


2.290.00 


,','ln,' Sn 


1 


1.440 00 


1,728.00 


1 011 20 


1 '.4.1 :■'. 


2,160.00 


2.S/nno 


2 


664.00 


2.880.00 


'.. 1" 


4 


1.735.00 


2,082.00 


2.307.55 


..' '-1 ' ."■ 


2,602.50 


ion, ,.'S 


3 


209.75 


3.470.00 


4 ( ',/ Of, 


5 


2.030 00 


2,436.00 


2.699.90 


.; MUSI. 


3,045.00 


1.SS2 'Mi 


"1 


755.50 


4,060.00 


s. 07s 00 


6 


2,325.00 


2,790.00 


3.092.25 


3.138.75 


3.487.50 


1.088 /', 


4 


301.25 


4.650.00 


0,81. :< SO 


7 


2,620 00 


3,144.00 


3.484.60 


3.537 00 


3,930.00 


1 „■,....,, 


4 


847.00 


5.240.00 


i-,00n 1,0 


8 


j 'ilSlili 


3,49800 


3.876.95 


1 935.25 


4 :/..' so 


5.101 25 


5 


c ■ .". 


5,830.00 


7,287 50 



MEDICALLY NEEDY 




The medically needy have too much money (and in some 
cases resources like savings) to be eligible as categorically 
needy. If a state has a medically needy program, it must 
include pregnant women for a 60-day postpartum period, 
children under age 18, certain newborns for one year, certain protected 
blind persons and persons required to sign up for their employer's 
health plan if it is cost-effective. States may also include: 

■ Children under age 21, 20, 19, or 18 or under age 19 who are 
full-time students. If a state doesn't want to cover all of these 
children, it can limit eligibility to reasonable groups of 

such children. 

■ Caretaker relatives (relatives who live with and take care of children). 

■ Aged persons (age 65 and older). 

■ Blind persons (blindness is determined using the SSI program 
standards or state standards). 

■ Disabled persons (disability is determined using the SSI program 
standards or state standards). 

■ Persons who would be eligible if not enrolled in an HMO. 
36 states have medically needy programs: 



Arkansas 


Hawaii 


Maine 


Nebraska 


Oklahoma 


Utah 


California 


Illinois 


Maryland 


New Hampshire 


Oregon 


Vermont 


Connecticut 


Iowa 


Massachusetts 


New Jersey 


Pennsylvania 


Virginia 


Dist. of Columbia 


Kansas 


Michigan 


New York 


Rhode Island 


Washington 


Florida 


Kentucky 


Minnesota 


North Carolina 


Tennessee 


West Virginia 


Georgia 


Louisiana 


Montana 


North Dakota 


Texas 


Wisconsin 


Note: Texas' medically needy program covers only the 


"mandatory" medically needy groups. 


It does not cover 


the aged, blind and disabled. Oregon's program excludes pregnant women 


and children under a waiver. 



SPECIAL GROUPS 




Medicare Beneficiaries— Medicaid pays Medicare 

premiums, deductibles and coinsurance for 

"Qualified Medicare Beneficiaries (QMB)"— 

individuals whose income is below 100% of the 

Federal poverty level and whose resources are no 

more than twice the value allowed under SSI. There are additional 

groups for whom Medicare related expenses are paid by Medicaid 

when the individuals' income is below varying poverty levels- 

120% and between 135% and 175%. 

Qualified Working Disabled Individuals-Medicaid can pay 
Medicare Part A premiums for certain disabled individuals who 
lose Medicare coverage because of work— individuals whose 
income is below 200% of the Federal poverty level and resources 
that are no more than twice the value allowed under SSI. 

States may also improve access to employment, training and 
placement of people with disabilities who want to work though 
expanded Medicaid eligibility. Eligibility can be extended to 



working disabled people between ages 16 and 65 who have 
income and resources greater than that allowed under the SSI 
program. States can extend eligibility even more to include 
working individuals who become ineligible for the group described 
above because their medical conditions improve. States may 
require such individuals to share in the cost of their medical care. 

There are two new eligibility groups that states may include under 
their Medicaid plans. One is for women who have breast or cervical 
cancer and the other for people with Tuberculosis (TB) who are 
uninsured. Women with breast or cervical cancer receive all plan 
services while TB patients receive only services related to treatment 
of TB. The charts below identify the states that include these 
groups under their Medicaid plans. 

States including people with TB: 



California 




Florida Minnesota 


Oklahoma 


Wyoming 


Dist. of Columbia 


Louisiana New York 


Utah 




States including 


women with breast or cervical cancer: 




Alabama 


Florida 


Kansas Missouri 


North Carolina 


Utah 


Arizona 


Georgia 


Kentucky Montana 


North Dakota 


Vermont 


Arkansas 


Hawaii 


Louisiana Nebraska 


Oregon 


Virginia 


California 


Idaho 


Maine Nevada 


Pennsylvania 


Washington 


Colorado 


Illinois 


Maryland New Hampshire 


Rhode Island 


West Virginia 


Connecticut 


Indiana 


Michigan New Jersey 


South Carolina 


Wisconsin 


Delaware 


Iowa 


Mississippi New Mexico 


South Dakota 


Wyoming 



Some states have also expanded eligibility under Medicaid waivers. Often 
the expanded eligibility is only for people who enroll in managed care. 



States with 1115 statewide, expanded eligibility waivers: 



Arizona 

Arkansas 

Delaware 



Dist. of Columbia 

Hawaii 

Kentucky 



Maryland 

Massachusetts 

Minnesota 



Missouri 
New York 
Oklahoma 



Oregon 
Rhode Island 
Tennessee 



Vermont 

Washington 

Wisconsin 



Note: No new eligibles are currently under the Kentucky, Maryland, and Oklahoma programs. Utah's program 
hasn't been implemented. States also enroll beneficiaries in managed care through 1915(b) waivers. Only two 
states, Alaska and Wyoming, do not include managed care in their Medicaid program. 

■ All states provide community Long Term Care services for 

individuals who are Medicaid eligible and qualify for institutional 
care. Most states use eligibility requirements for such individuals 
that are more liberal than those normally used in the community. 

To find out more about Medicaid in your State call the toll free 
number for your State. A list of toll free numbers can be reached 
through the CMS website, http://www.cms.hhs.gov/medicaid/mcontact. 

Find out more about Medicare by calling 1-800-MEDICARE or 
going to http://www.medicare.gov. 



STATE CHILDREN'S HEALTH 
INSURANCE PROGRAMS 



State Children's Health Insurance Programs (SCHIPs) 
provide health insurance to children up to age 19. These 
programs are for children whose parents have too much 
money to be eligible for Medicaid, but not enough to buy 
private insurance. Most states offer this insurance 
coverage to children in families whose income is at or below 200% of 
the Federal poverty level. However, because states have different 




income eligibility requirements, you need to find out about the program 
in your state. Not all the insurance programs provide the same benefits, 
but they all include shots (immunizations) and care for healthy babies 
and children at no cost. Families may have to pay a small amount (co- 
payment) for other services depending on their income. 

While states call their child health insurance programs by different 
names, you should be able to find out about the program in your state 
by asking for the State Children's Health Insurance Program or calling 
1-877-KIDS NOW (1-877-543-7669). 

For more detailed SCHIP information see the following websites: 
http://www.cms.gov/schip/consumers and http://www.cms.gov/schip/stateplan. 



MANDATORY STATE PLAN SERVICES 




CATEGORICALLY NEEDY ELIGIBILITY GROUPS: 

Medicaid eligibility groups classified as categorically 
needy are entitled to the following services unless waived 
under section 1115 of the Medicaid law. These eligibility 
groups do not apply to the SCHIP programs: 

■ Inpatient hospital (excluding inpatient hospital services for 
mental disease). 

■ Outpatient hospital including Federally Qualified Health Centers 
(FQHCs) and if permitted under state law, rural health clinic and 
other ambulatory services provided by a rural health clinic which 
are otherwise included under states' plans. 

Other laboratory and x-ray. 

Certified pediatric and family nurse practitioners (when licensed to 
practice under state law). 

Nursing facility services for beneficiaries age 21 and older. 

Early and periodic diagnosis and screening (EPSDT) for children 
under age 21. 

Family planning services and supplies. 

Physicians' services. 

Medical supplies and surgical services of a dentist. 

Home health services for beneficiaries who are entitled to nursing 
facility services under the state's Medicaid plan. 

• Intermittent or part-time nursing services provided by home 
health agency or by a registered nurse when there is no home 
health agency in the area. 

• Home health aides. 

• Medical supplies and appliances for use in the home. 

Nurse mid-wife services. 

Pregnancy related services and service for other conditions that 
might complicate pregnancy. 

O^Hbrarv 

C2-07-13 | 

7500 Security Bivd. 

\ Baltimore, Maryland 21244 _____ „.„.„,,.„.,,,...■ 



■ 60 days postpartum pregnancy related services. 

Note: Under the EPSDT program, states are required to provide all medically necessary services. This 
includes services that would otherwise be optional services. If an optional service is only available through 
the EPSDT program, it will not appear on the state chart. 

MEDICALLY NEEDY ELIGIBILITY GRDUPSI 

States must provide at least the following services when the medically 

needy are included under the Medicaid plans: 

■ Prenatal and delivery services. 

■ Post partum pregnancy related services for beneficiaries under age 
18 and who are entitled to institutional and ambulatory services 
defined in a state's plan. 

■ Home health services to beneficiaries who are entitled to receive 
nursing facility services under the state's Medicaid plan. 

■ Specific services for beneficiaries in institutions for mental disease 
and/or intermediate care facilities for the mentally retarded if 
included as medically needy. 

States may include any other services described under Medicaid law 
subject to any limits based on comparability of services. States may 
provide different services to different groups of medically needy (example 
under age 18 and aged). However, unless there is a waiver, the services 
provided to a particular group must be available to everyone within that 
group. The chart does not reflect different services for the different 
medically needy sub-groups— only that at least one group gets the service. 



STATE CHART 

(See reverse side) 



OPTIONAL MEDICAID STATE PLAN SERVICES: 

The services reflected on this chart are only the optional 
state plan services that states have elected to include 
under their plans and managed care waivers as of 
November 2002. (See http://www.cms. hhs.gov/medi- 
caid/state plans, http://www.cms.hhs.gov/medicaid/managed care or 
the state for up-to-date information.) The eligibility groups that are 
entitled to each service are identified. The chart does not include 
services provided under the SCHIP programs or additional non-plan 
services that may be provided through waiver programs or managed 
care organizations. The chart also does not reflect the services that 
states are required to provide. A description of those services and the 
services for the optional medically needy eligibility groups are 
described above. 

The chart identifies limits on services, but it doesn't reflect what type 
of limit is imposed. Generally, these limits are on the number of visits, 
days a service may be provided or items of services like prescriptions that 
may be filled in a specified time. It is important to note that states may 
under waiver authority, also be imposing additional limits on sub-groups 
of the eligibility categories listed. 

FEDERAL/STATE MATCHING RATES FOR SERVICES! 

The Medicaid program is funded through federal and state funds. States 
have different Federal matching rates to fund the services provided 
under their Medicaid programs. The statutory Federal matching rates 
for each state for Fiscal years 2002 and 2003 are reflected on the chart. 






















/ OCN = Optional Categorically Needy Groups Only ♦ MN = Medically Needy Only ft 
■ ACN = All Categorically Needy X AP = Additional Populations Jed 








Other Licensed Practitioners 




2002 2003 
FMAP FMAP 


en 
O 
O 
ro 

Q. 

o 

!c 

O 


in 
to 

o 
0. 


to 

E 
o 

Q. 

O 


to 

D) 
O 
O 

-C 
CJ 

>> 
(/) 
0_ 


To 

% 

.c 
to 

<B 
C 
< 

in 

Z 


70.45 


70.60 


Alabama 


A+ 


A+ 


A+ 


A+ 


A+ 


: 


57.38 


58.27 


Alaska 






■+ 








64.98 


67.25 


Arizona 




A+ 


A+ 


A 


A 




72.64 


74.28 


Arkansas 


A+ 


A+ 


A+ 




A 




51.40 


50.00 


California 


A+ 


A+ 


A+ 


A+ 


A+ 




5000 


50.00 


Colorado 




A 


A 


A 


A 


, 


50.00 


50.00 


Connecticut 


A+ 


A 


A+ 


A+ 






50 00 


50.00 


Delaware 




■+ 


■ + 








70.00 


70.00 


D.C. 




A+ 


A+ 








56 43 


58.83 


Florida 


A+ 


A+ 


A+ 




A 




59.00 


59.60 


Georgia 




A+ 


A+ 


■+ A 


A 




56.34 


58.77 


Hawaii 




A+ 


A+ 


A+ 






71.02 


70.96 


Idaho 


■+ 


■+ 


■+ 








50.00 


50.00 


Illinois 


A+ 


A+ 


A+ 




A 




62.04 


61.97 


Indiana 


■+ 


■ 


■ 


■ 


■ 




62.86 


63.50 


Iowa 


A + 


A+ 


A+ 


A+ 






60 20 


60.15 


Kansas 


A+ 


A+ 


A+ 


A+ 


A+ 




69.94 


69.89 


Kentucky 


A 


A+ 


A+ 








70.30 


71.28 


Louisiana 




A+ 


A+ 








66.58 


66.22 


Maine 


A+ 


A+ 


A+ 


A+ 






50.00 


50.00 


Maryland 


A+ 


A+ 


A+ 




A+ 




50.00 


50.00 


Massachusetts 


A+ 


A+ 


A+ 


A+ 






56.36 


55.42 


Michiqan 


A+ 


A+ 


A+ 




A+ 




50.00 


50.00 


Minnesota 


A+ 


A+ 


A+ 


A+ 


A 




76.09 


76.62 


Mississippi 


A+ 


A+ 


A+ 


A+ 






61.06 


61.23 


Missouri 




■+ 


■+ 








72.83 


72.96 


Montana 




A+ 


A+ 


A+ 


A+ 




59.55 


59.52 


Nebraska 


A+ 


A+ 


A+ 




A+ 




50.00 


52.39 


Nevada 






A+ 


A+ 


A+ 




50.00 


50.00 


New Hampshire 


A+ 


A+ 


A+ 


A+ 






50.00 


50.00 


New Jersey 


A+ 


A+ 


A+ 


A+ 






73.04 


74.56 


New Mexico 




A+ 


A+ 


A+ 


A+ 




50.00 


50.00 


New York 






A+ 


A+ 




" 


61.46 


62.56 


North Carolina 


A+ 


A+ 


A+ 


A+ 


A+ 




69.87 


68.36 


North Dakota 


A+ 


A 


A+ 


A 






58.78 


58.83 


Ohio 


A+ 


A+ 


A+ 


A+ 


A+ 




70.43 


70.56 


Oklahoma 




A+ 


A 




A 




59.20 


60.16 


Oregon 


A+ 


A+ 


A+ 






■ 


54.65 


54.69 


Pennsylvania 


A+ 


A+ 


A+ 


A+ 






52.45 


55.40 


Rhode Island 




■ + 


A+ 








69.34 


69.81 


South Carolina 


A + 


A+ 


A+ 




A+ 




65.93 


65.29 


South Dakota 


A+ 


A+ 


A+ 




A+ 


I 


63.64 


64 59 


Tennessee 




A+ 


A+ 


A 


A 


■ r 


60.17 


59.99 


Texas 


A+ 


A 


A+ 


A+ 


A+ 




70.00 


71.24 


Utah 


A+ 


A+ 


A+ 


A+ 






63.06 


62.41 


Vermont 


A+ 


A+ 


A+ 


A+ 






51.45 


50.53 


Virqinia 




A+ 


A + 


A+ 






50.37 


50.00 


Washington 




A+ 


A + 


■+ 


■+ 




75.27 


75.04 


West Virginia 


A 


A 


A 


A 


A 




58.57 


58.43 


Wisconsin 


A+ 


A+ 


A+ 


A+ 


A+ 




61.97 


61.32 


Wyoming 






A+ 




A+ 








Totals: 


32 


47 


51 


32 


28 





Totals = Total number of States and District of Columbia thai provide the service to one or more categories of eligible 



50.00 


50.00 


Puerto Rico 




A+ 


A+ 








50.00 


50.00 


Virgin Islands 






A+ 









Note: Only Mandatory Services are required for American Samoa. Guam, and N. Mariana Islands 
Note: All services provided by Puerto Rico are provided by Managed Care. 
Note: The FMAP for the territories is 50.00. 



E D I C A I D 



■ Medically Needy Group) 
id through 1115 Waivers 



A ALL = All Eligibility Groups that States Covers 
+ Limits = Limit of some type on the service 





■o 
3 

1 8 

«5 o 
>> c 

x: ss 
Q.O 


W 

LU 

1 

CO 


Home Health Therapies 


3 
c 

a> 
Q 


>, 

Q. 

ro 

CD 

1- 

15 
o 
t/i 
>. 

n 
0- 


Q. 

ro 
<D 

.c 
\~ 

ro 
c 
q 

Q. 

O 
CJ 

O 


o 
CL 


CD 
O) 

CO 

O) 

c 
ro 
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c 
ra 
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o 
CD 

CD 
Q. 
CO 


ro 
c 
q 

a. 

o 
u 
O 


<D 
O 

£ 

m 
CO 

>. 

D) 

O 

o 

< 




A+ 


AL 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




■+ 


AK 


■+ 


■+ 


■+ 


■+ 


■+ 


■+ 


■+ 




A 


AZ 


■+ 


■+ 


■+ 




A+ 


A 


A+ 




A+ 


AR 


A+ 


A+ 


A+ 




A+ 


A+ 


A+ 




A+ 


CA 


A+ 


A + 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


CO 


A+ 


A+ 


A+ 


A+ j 










A+ 


CT 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 






■+ 


DE 


■+ 


■ + 




■+ 










A+ 


DC 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


FL 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


GA 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


HI 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




■+ 


ID 


■+ 


■+ 


■+ 


■+ 


■+ 


■ + 






A 


IL 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




■ 


IN 


■ 


■ 


■ 


■ 


■+ 


■+ 


■+ 




A+ 


IA 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


KS 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A + 




A+ 


KY 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


LA 


A+ 


A+ 


A+ 












A 


ME 


A+ 


A+ 


A+ 


A+ 


A+ 


A 


A+ 




A+ 


MD 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 






A+ 


MA 


A 


A 


A 


A+ 


A+ 


A+ 


A+ 




A+ 


Ml 


A+ 


A+ 


A+ 


A+ 


A+ 








A+ 


MN 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


MS 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




■+ 


MO 


■+ 


■+ 


■+ 


■+ 


■+ 








A+ 


MT 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


NE 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


NV 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


NH 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


NJ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


NM 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


NY 


A 


A 


A 


A 


A+ 


A+ 


A+ 




A+ 


NC 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A 


ND 


A+ 


A+ 


A+ 


A+ 


A+ 


A 


A 




A+ 


OH 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


OK 










A+ 










OR 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


PA 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


Rl 


A+ 


A+ 


A+ 


A+ 


A+ 








A+ 


SC 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


SD 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 






A 


TN 


A+ 


A+ 


A+ 


A+ 


A+ 


■ *X+ 


■ *X+ 




A+ 


TX 


A+ 




A+ 






A+ 






A+ 


UT 


A+ 


A+ 


A + 


A+ 


A+ 


A+ 


A+ 




A+ 


VT 


A+ 


A+ 


A+ 


A+ 


■ +♦+ 


A+ 


A+ 




A+ 


VA 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A 


WA 


A+ 


A+ 


A+ 


A+ 


A + 


A+ 


A+ 




A 


WV 


A 


A 


A 


A+ 


A+ 


A 


A 




A+ 


Wl 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




A+ 


WY 


A+ 


A+ 


A+ 




A+ 


A+ 






50 


- 


50 


49 


49 


45 


47 


44 


38 







PR 










A+ 


A+ 


A+ 






VI 










A+ 













EDICAID SERVICES 



PLAN CHART 



i miTi nnnuniri i, 



II Eligibility Groups that Stales Cove 



alegoncally needy groups. 



( )' - Delaware, Indiana, Now York, t 




\n 






, c, ', j Ubrary 

17-13 - , 

St ■ 






• ♦ 



Othtr 
M»dlca1 or Rom.cllal 

' ' ■■■•'!■■• 



55 




CHS LIBRARY 
UN 





3 80=15 DDD.imDI b 



5 Librarv 



■ - x 3 
•■-. sty Blvd. 

vc. Maryland 21244 



( ) 2 = South Dakota and Idaho chose: Skilled nursing facility services only 
provided to beneficiaries age 65 and older in institutions for mental disease. 





Ui 

1- 


O CD 

£c 

o g- 

-1 

i- CD 
Q.33 

<d <d 
a: > 


CD >> 
> ~ 

o LU 

£ CD 

— x; 

< i 

— ' o 

UJ "~ 

O £ 

< CO 

Q- O 


Other 

Medical or Remedial 

Care Services 


in 

UJ 


ra r- 
.2 o 

"O S3 
CD 3 

Z CD 

O JZ 

:= CO 
CD CD 

rr x 


Q) 
O 

CD > 

C § 
O en 

i| 

« < 

CO o 

H 21 


CM 
CD 

< 

3Md 

= T3 
O C 

"^ 

™ m 
CJ) CD 

<= cj 
£'£ 

3 CD 

z w 


Emergency Hospital 
Services in Non- 
Medicare Participating 


'5. 

c/5 

o 

I 

Cfl 
CA 

CD 

cj 

CJ 

< 

"co 

CJ 

o 




AL 








A+ 


A+ 






AL 




AK 


■+ 






■+ 


■+ 






AK 




AZ 


■ 




A 


A+ 


A 


A 


A 


AZ 




AR 








A+ 


■+ 


A+ 


A+ 


AR 




CA 






A+ 


A+ 


A+ 


A+ 


A+ 


CA 




CO 




A+ 




A+ 


A 


A 


A+ 


CO 




CT 




A 




A+ 


A 






CT 




DE 










■ 






DE 




DC 








A+ 


A 


A+ 




DC 




FL 




A 




■+ 


■+ 


A+ 




FL 




GA 








A+ 


A+ 






GA 




HI 


A+ 






A+ 


A+ 


A+ 


A+ 


HI 




ID 








■ + 


■+ 


■+ 




ID 




IL 


A 


A 


A 


A 


A 


A 




IL 




IN 






■ 


■ 


■ 


■ 




IN 




IA 








■ +♦ + 


■+ 




■ +♦+ 


IA 




KS 




A 




A+ 


A+ 


A+ 


A+ 


KS 




KY 








A+ 


A+ 


A+ 




KY 




LA 








A+ 


A+ 






LA 




ME 






A 


A+ 


A 


A 




ME 




MD 




■ 




A+ 


A+ 


A+ 




MD 




MA 








A+ 


A+ 


A 




MA 




Ml 


A+ 


A+ 


A+ 


A+ 


A+ 


A+ 




Ml 




MN 






A 


A+ 


A+ 


A+ 


A+ 


MN 




MS 








A+ 


A+ 


A+ 




MS 




MO 




■ 






■+ 




■+ 


MO 




MT 








A+ 


A+ 


A+ 


A+ 


MT 




NE 








A+ 


A+ 


A+ 


A+ 


NE 




NV 


A+ 






A+ 


A+ 






NV 




NH 








A+ 


A+ 


A+ 




NH 




NJ 






■+ 


A+ 


■+ 


■ + 




NJ 




NM 








A+ 




A+ 




NM 




NY 








A+ 


A+ 


A+ 


A 


NY 




NC 


■+ 






A+ 


A+ 






NC 




ND 








A+ 


A 


A 


A+ 


ND 




OH 


A+ 


A 


A+ 


A+ 


A+ 


A+ 


A 


OH 




OK 










A + 




A+ 


OK 




OR 








A+ 


A 


A 




OR 




PA 


A+ 


A+ 


A+ 


A+ 


A+ 






PA 




Rl 








A+ 


A+ 






Rl 




SC 




■ 




A+ 


A+ 


A+ 




SC 




SD 








A+ 


A 


A 


A+ 


SD 




TN 


A 


■ ♦ 




■ +♦+ 


■ ♦ 


A 




TN 




TX 


A+ 




A+ 


A+ 


A+ 


A+ 




TX 




UT 








A+ 


A+ 


A 


A+ 


UT 




VT 


■ ♦ 






■ +♦ + 


■ +♦+ 


A+ 




VT 




VA 






A 


A+ 


A 


A 


A 


VA 




WA 


A 


■ 




A+ 


A+ 


A 




WA 




WV 


A 






A 


A 




A 


WV 




Wl 


A + 




A+ 


A+ 


A+ 


A 


A 


Wl 




WY 








A+ 


A 


A+ 


A+ 


WY 




- 


15 


13 


13 


48 


50 


37 


21 


-- 





PR 








A+ 








PR 




VI 


A+ 






A + 








VI 



Source: Approved Medicaid plans and waivers as of November 2002. 



Publication No. CMS-1 1024-02 

Use 410-786-1905 to tax requests for additional copies.